Page 30 - Jourmal of World Association of Laparoscopic Surgeon
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Shereen Pradeep Kumar

             significant decrease in the operative blood transfusion  8. Brumsted J, Kessler E, Gibon E, et al. A comparison of
             rate in those who underwent laparoscopy. Similar were  laparoscopy and laparotomy for the treatment of ectopic
                                                                  pregnancy. Obstet Gynecol 1988;71:889-902.
             the results in several other studies. 9,10,14,18  These articles  9. Vermesh M, Silva PD, Rosen GF, et al. Management of
             have also showed that postoperatively the requirement  unruptured ectopic gestation by linear salpingectomy a
             for analgesics was significantly less. 8,14          prospective randomized clinical trial of laparoscopy versus
          •  Hospital stay: All the studies here have reported a much  laparotomy. Obstet Gynecol 1989:73:400-04.
             shorter hospital stay following laparoscopic surgery and  10. El-Tabbakh MN, Elsays MS. Tubal ectopic pregnancy:
             there for proves to be cost effective. 8-11,14,17,18  Laparoscopy vs Laparotomy. Available from: www.Obgyn.Net/
                                                                  Pregnancy-Birth/Page/Pb/Articles/El-Tabbakh-Tubel-Ectopic.
          •  Fertility outcome: The concern for future fertility poses  11. Xiang XD, Tane YQ, Mao JFA. Comparison of laparoscopic
             a debate as there is a certain amount of damage to the  surgery and laparotomy in the treatment of ectopic pregnancy.
             lumen. But both methods of surgery have had          Singapore Med J 1999 Feb;40(2):88-90.
             comparable pregnancy outcomes. 9,13,14,18        12. Gray DT, Thorburn J, Lundorf P, et al. A cost effective study of
          •  Convalescence: Minimal access surgery has lead to a  a randomized trial of laparoscopy versus laparotomy. Lancet
                                                                  1995 May 6;345(8958):1139-43.
             better quality of life in term of shorter hospital stay,  13. Clasen K, Camus M, Tournaye H, et al. Ectopic pregnancy:
             faster recovery, decreased need for analgesics and   Let's cut ! Strict laparoscopic approach to 194 consecutive cases
             cosmetically better scar. 10,14,15                   and review of literature and alternatives. Human Reproduction
                                                                  1997;12(3);596-601.
          CONCLUSION                                          14. Murphy AA, Nager CW, Wujek JJ, Kettel LM, Torp VA,
                                                                  Chin HG. Operative laparoscopy versus laparotomy for the
          After critiquing several articles published over the past few  management of ectopic pregnancy: A prospective trial. Fertil
          years, the overview of literature confirms that minimally  Steril 1992 Jun;57(6):1180-85.
          access surgery is safe, effective and economical when  15. Sagiv R, Debby A, Sadan O, Malinger G, Glezerman M, Golan
          compared to open laparotomy as the surgical treatment for  A. Laparoscopic surgery for extrauterine pregnancy in hemo-
          ectopic pregnancy. It should be considered as the gold  dynamically unstable patients. J Am Assoc Gynecol Laparosc
                                                                  2001 Nov;8(4):529-32.
          standard method in managing ectopic pregnancies.    16. Chapron C, Querleu D, Crepin G. Laparoscopic treatment of
                                                                  ectopic pregnancies: A one hundred cases study. Eur J Obstet
          REFERENCES                                              Gynecol Reprod Biol 1991 Oct 8;41(3):187-90.
            1. Page EW, Villee CA, Villee DB. Human reproduction (2nd ed).  17. Zouves C, Urman B, Gomel V. Laparoscopic surgical treatment
              Philadelphia: WB Saunders 1976;211.                 of tubal pregnancy. A sage, effective alternative to laparotomy.
            2. Speroff L, Glass RH, Kase NG. Clinical gynecological  J Reprod Med 1992 Mar;37(3):205-09.
              endocrinology and infertility (6th ed). Lippincott Williams  18. Mohamed H, Maiti S, Phillips G. Laparoscopic management of
              Wilkins 1999;1149ff.                                ectopic pregnancy: A 5-year experience. J Obstet Gynaecol 2002
            3. Centres for diseases control (CDC). Ectopic pregnancy-United  Jul;22(4):411-14.
              States, 1988-1989. MMWR 1992;41:591-94.         19. Chatwani A, Yazigi R, Amin-Hanjani S. Operative laparoscopy
            4. Centres for disease control (CDC). Ectopic pregnancy-United  in the management of tubal ectopic pregnancy. J Laparoendosc
              States, 1990-1992. MMWR 1995;44:46-48.              Surg 1992 Dec;2(6):319-24.
            5. Why women die: Report on confidential enquiries into maternal
              deaths in the United Kingdom 1994-1996. Norwich: Stationery
              Office, 1998.                                   ABOUT THE AUTHOR
            6. Burhart MA, Mahens H, Magee E, Poultry JL. Treatment of  Shereen Pradeep Kumar
              ectopic pregnancy by means of laparoscopy. Fertil Strile 1980;
              33:411-14.                                      Registrar, Lakeshore Hospital and Research Centre, NH-47 Bypass
            7. Seeber BE, Barmhart KT. Suspected Ectopic Pregnancy. Obstet  Maradu, Nettoor PO, Kochi-682040, Kerala, India, e-mail:
              Gynecol 2006;107:399-413.                       shereenkumar@gmail.com



















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